title: Cystic and hemorrhagic giant left atrial myxoma in a patient presenting with exertional angina and dyspnea.
abstract: Myxomas are the most common type of primary cardiac tumors and are usually localized in the atrium. The clinical features of the disease depend on the size, location, mobility, and fragility of the mass. In our case report, we present a 38-year-old female patient admitted to our hospital with typical exertional angina and dyspnea. Diagnosis of giant cystic/hemorrhagic atrial myxoma was established after imaging modalities including echocardiography, angiography, and radiology and the pathological evaluation of the mass. On the coronary angiography, a significant feeding artery of the tumor originating from the right coronary artery and the cystic/hemorrhagic appearance all raised the suspicion for the presence of other cardiac masses. However, the pathological evaluation of the mass was reported as consistent with myxoma, with many prominent cystic and hemorrhagic fields and no evidence of malignancy. Since large intratumoral hemorrhagic fields and the presence of a significant feeding artery secondary to tumor neovascularization were observed, we hypothesized that the remarkable amount of blood flow from the coronary artery to the giant myxoma may result in a kind of coronary steal phenomenon and typical anginal symptoms of the patient.
authors.affiliation: Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara, Turkey. sadik.acikel@tkd.org.tr
authors.forename: Sadik
authors.initials: S
authors.lastname: Acikel
authors.forename: Murat Muhammed N
authors.initials: MM
authors.lastname: Aksoy
authors.forename: Harun
authors.initials: H
authors.lastname: Kilic
authors.forename: Kasim
authors.initials: K
authors.lastname: Karapinar
authors.forename: Ayse Selcen
authors.initials: AS
authors.lastname: Oguz
authors.forename: Hasan
authors.initials: H
authors.lastname: Aydin
authors.forename: Ramazan
authors.initials: R
authors.lastname: Akdemir
mesh_terms: D000328:Adult; D060050:Angina, Stable / Q000175:diagnosis* / Q000209:etiology; D017023:Coronary Angiography; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D006325:Heart Atria / Q000473:pathology* / Q000601:surgery; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D009232:Myxoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery